A sexualidade no processo do envelhecimento: novas perspectivas - comparação transcultural

As terapias de reposição hormonal assim como as novas moléculas (sildenafil, tadalafil) que lutam contra as disfunções da ereção revelaram a demanda crescente na área da saúde sexual na segunda metade da vida. Entretanto, o lugar da sexualidade no processo de envelhecimento constitui um assunto particularmente contaminado por preconceitos. A complementaridade entre a teoria sociológica e a teoria psicanalítica permite esclarecer a dupla natureza deste fenômeno, em que o recalcamento intrapsíquico é fruto, em primeiro lugar, dos ideais culturais interiorizados. Com o propósito de uma comparação transcultural, procedeu-se à aplicação de um questionário amplo a duas amostras, uma brasileira e outra portuguesa, de maneira a caracterizar conhecimentos, atitudes, crenças e práticas sobre a vivência do corpo e da sexualidade de 187 pessoas entre 52 e 90 anos gozando de boa saúde física e mental.Access to new drugs (tibolona, sildenafil, tadalafil) revealed an increasing demand of seniors about their sexual health. However, prejudices about older people's sexuality remain prevalent in our culture. Sociological and psychoanalytical theories combined allow understanding the double nature of this phenomenon, in which intrapsychic repression results of internalized cultural ideals. This article presents a transcultural survey comparing two samples, Brazilian and Portuguese, to verify knowledge, attitudes, beliefs and practices about sexuality of 187 healthy people, 52 to 90 years old

Brain 1H-MR spectroscopy in clinical neuroimaging at 3T

After more than 10 years of use, clinical neuroimaging spectroscopy has proven to be invaluable in the MRI assessment of several brain diseases. The metabolic characterization of diverse brain lesions and pathological conditions is well established by spectroscopy studies at 1.5T, but recently, an increase in the number of 3T magnets has noticeably improved routine neuroimaging in general. For brain proton spectroscopy, the use of higher magnetic fields has been promising in terms of increasing the signal/noise ratio across the spectrum and widening the frequency bandwidth to allow clearer separation of peaks that are otherwise too close to each other at 1.5T, especially glutamate, glutamine and gamma-aminobutyric acid (GABA). The individual detection and quantification of these metabolites will add more details to the characterization of brain diseases, and allow the inclusion of more brain pathologies. Moreover, the ongoing advances in dedicated hardware and integrated software have led to more accurate and automated postprocessing, offering neuroradiologists a more user-friendly interface. This is an up to date review of the main clinical applications of brain proton MR spectroscopy that are potentially improved at 3T, taking into account the peculiarities of higher magnetic fields. It is based on both the literature and our own clinical experience, starting from July 2005 and including more than 250 scans at 3T (unpublished material), and emphasizes, for every indication, a practical approach to brain MRS to achieve the optimal clinical impact. © 2008 Elsevier Masson SAS. All rights reserved.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Neurochemical Alterations in Methamphetamine-Dependent Patients Treated with Cytidine-5′-Diphosphate Choline: A Longitudinal Proton Magnetic Resonance Spectroscopy Study

Cytidine-5′-diphosphate choline (CDP-choline), as an important intermediate for major membrane phospholipids, may exert neuroprotective effects in various neurodegenerative disorders. This longitudinal proton magnetic resonance spectroscopy ((1)H-MRS) study aimed to examine whether a 4-week CDP-choline treatment could alter neurometabolite levels in patients with methamphetamine (MA) dependence and to investigate whether changes in neurometabolite levels would be associated with MA use. We hypothesized that the prefrontal levels of N-acetyl-aspartate (NAA), a neuronal marker, and choline-containing compound (Cho), which are related to membrane turnover, would increase with CDP-choline treatment in MA-dependent patients. We further hypothesized that this increase would correlate with the total number of negative urine results. Thirty-one treatment seekers with MA dependence were randomly assigned to receive CDP-choline (n=16) or placebo (n=15) for 4 weeks. Prefrontal NAA and Cho levels were examined using (1)H-MRS before medication, and at 2 and 4 weeks after treatment. Generalized estimating equation regression analyses showed that the rate of change in prefrontal NAA (p=0.005) and Cho (p=0.03) levels were greater with CDP-choline treatment than with placebo. In the CDP-choline-treated patients, changes in prefrontal NAA levels were positively associated with the total number of negative urine results (p=0.03). Changes in the prefrontal Cho levels, however, were not associated with the total number of negative urine results. These preliminary findings suggest that CDP-choline treatment may exert potential neuroprotective effects directly or indirectly because of reductions in drug use by the MA-dependent patients. Further studies with a larger sample size of MA-dependent patients are warranted to confirm a long-term efficacy of CDP-choline in neuroprotection and abstinence